A total of 37 states and the District of Columbia have laws related to autism and insurance coverage. And recently, the Center for Medicare & Medicaid Services (CMS) announced that in many of these states, Medicaid, Medicare, the federal Children’s Health Insurance Programs (CHIP), and all commercial carriers must provide autism-spectrum coverage.
See also: Calif. health plans must provide behavioral analysis coverage.
Cue a round of applause.
This recent change is an incredible victory for children and adults with autism, and it comes at the right time: The Centers for Disease Control and Prevention just released a report that showed a 30 percent increase in the number of children with autism within the last two years. This means that, in the United States, one in 68 children needs treatment for autism.
The ramifications of not providing coverage for autism treatments
With autism on the rise, it’s crucial that insurance companies take the initiative to cover treatment options.
Autism treatment options, including applied behavior analysis (ABA), occupational therapy services, and social skills groups, have helped thousands of children and adults living with autism lead more normal lives. But if that’s the case, then the question is: Why did it take so long for insurers to cover autism care?
See also: Applied Behavioral Analysis Suit Wins Class-Action Status.
Up until now, insurance plans haven’t wanted to cover autism treatments because there’s no way to control or predict the cost of these services (ABA costs an average of $50,000 per year, for example). What’s more, autism-spectrum disorders cover a range of impairments, from mild to profound.